Provider Demographics
NPI:1881629160
Name:NOVAK, BERKOWITZ AND ROSENBERG, PC
Entity Type:Organization
Organization Name:NOVAK, BERKOWITZ AND ROSENBERG, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:L
Authorized Official - Last Name:DONAHUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-621-5822
Mailing Address - Street 1:532 S AIKEN AVE
Mailing Address - Street 2:SUITE 520
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1521
Mailing Address - Country:US
Mailing Address - Phone:412-621-5822
Mailing Address - Fax:412-621-3974
Practice Address - Street 1:532 S AIKEN AVE
Practice Address - Street 2:SUITE 520
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1521
Practice Address - Country:US
Practice Address - Phone:412-621-5822
Practice Address - Fax:412-621-3974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE006128P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1009203640001Medicaid
PA1009203640001Medicaid